People with serious mental illness are still living 15-20 years less than the rest of the population, according to a study from the Nordic countries.

The study, published in the December issue of the British Journal of Psychiatry, shows that the life expectancy gap has remained largely unchanged over the last 20 years, despite changes to the provision of mental health services and improvements in public healthcare.

Researchers from the Nordic Research Academy in Mental Health in Sweden studied the life expectancy of people admitted to hospital for a mental disorder in Denmark, Finland and Sweden between 1987 and 2006. They found that those with a mental disorder had a two- to threefold higher mortality than the general population in all three countries.

The gap in life expectancy did decrease slightly between 1987 and 2006 in Denmark and Finland, especially for women. Overall, however, progress was modest. The notable exception was in Sweden, where no progress was made in reducing the life expectancy gap for men with mental disorders.

Lead researcher Professor Kristian Wahlbeck said:

Our study shows that major health inequalities persist between people with mental disorders and the rest of the population. Men with mental disorders still live 20 years less, and women 15 years less, than the general population.

The researchers put forward several explanations for the higher mortality rate among people with mental disorders. Professor Wahlbeck said:

These include an unhealthy lifestyle, inadequate access to good-quality physical healthcare, and a culture of not taking physical disease into consideration when treating psychiatric patients. In addition, people with mental illness are more often poor, unemployed, single and marginalised, all known risk factors for poor health and premature mortality.

Writing in an editorial in the same issue of the British Journal of Psychiatry, Graham Thornicroft, Professor of Community Psychiatry at the Institute of Psychiatry, King’s College London, described the study’s findings as “a scandal”.

Professor Thornicroft said:

Even in three Scandinavian countries that provide among the best-quality and most equitably distributed healthcare in the world, this mortality gap has narrowed only by a modest extent over the past two decades and remains stubbornly wide. There is now strong evidence that people with mental illness receive worse treatment for physical disorders. Medical staff, guided by negative stereotypes, often tend treat the physical illnesses of people with mental illness less thoroughly and less effectively.

Professor Thornicroft continued:

If such a disparity in mortality rates affected a less stigmatised section of the population, then we would witness an outcry. The fact that life expectancy remains about 20 years less for men with mental illness and 15-years less for women with mental illness, denotes a cynical disregard for these lost lives and shows, in stark terms, by just how much people with mental illness are valued less than others in our society. This can justifiably be seen a violation of the ‘right to health’ as set out in Article 12 ‘The right to the highest attainable standard of health’ in the International Covenant on Economic, Social and Cultural Rights.

Professor Wahlbeck called for clear health promotion actions, improved access to healthcare for people with mental illness, and stronger suicide prevention policies, especially in Sweden, to help reduce the life expectancy gap.

André started the Mental Elf website in May 2011.
He has worked as an Information Scientist in Mental Health since the late nineties; initially at Oxford University's Centre for Evidence-Based Mental Health and since 2002 as the Managing Director of Minervation Ltd.
He loves blogging, social media and elves! He also has established interests in evidence-based healthcare, usability testing and web design.

A major contributing factor to dying earlier than the general population (12-15 yrs ) is the effect of longterm use pf psych drugs. These contribute to cardiac problems, stroke, diabetes, huge weight gain and all its problems, possible brain damage.

I have EUBPD. The first time I was offered DBT treatment for it, I never got the appointment. After moving to Bournemouth I asked a doctor for help as I had been previously diagnosed with this condition while living in Leeds. That Doctor denied I had a problem! It has actually taken for me to be so discriminated by society for this that I have now lost my children due to it, now the doctor has admitted I have a problem and I am doing the DBT I should have had 14years ago. However had there not been such a screw up in the first place, my children would still be with me. So yes I understand the risks associated with mental health, and less people would die if the nhs got its act together and local authorities stopped stigmatizing parents who have to live with mental health issues.

[…] general population. Among those with severe mental disorders, life expectancy is reduced by around 15 to 20 years, which is equivalent, or worse than, the detrimental effect of heavy smoking (Chesney et al., […]